高频振荡通气治疗新生儿重症呼吸衰竭  

作　　者：黄蕴[1] 赵映敏[1] 朱敏[1] 俞玲玲[1] 李剑云[1] 

机构地区：[1]江苏靖江市人民医院

出　　处：《当代医学》2011年第18期8-10,共3页Contemporary Medicine

摘　　要：目的观察高频振荡通气(HFOV)与常频机械通气(CMV)对新生儿呼吸衰竭的临床效果。方法选择2009年9月～2011年l月住院治疗的呼吸衰竭新生儿53例,随机分为HFOV组和CMV组。HFOV组25例呼吸衰竭新生儿采用HFOV治疗,CMV组28例呼吸衰竭新生儿采用CMV治疗,将两组治疗前后的血气指标变化、用氧浓度、上机时间、并发症发生率及治愈率进行对比分析。结果与机械通气前相比HFOV2h后PCO2即明显下降(P<0.05),与CMV组比较差异极为显著(P<0.01)。8h后下降极为显著(P<0.01),与CMV组比较有显著性差异(P<0.05);HFOV治疗8h后氧合功能明显改善,表现为FiO2、OI、MAP均明显下降(P<0.05),与CMV组比较均有显著性差异(P<0.05),24h～48h后氧合功能进一步改善,FiO2、OI、MAP均进一步下降,患儿临床症状明显好转。与CMV组比较HFOV治愈率高、机械通气时间缩短、气胸及VAP发生率下降(P值均<0.05),但III级以上颅内出血发生率差异无明显(P>0.05)。结论 HFOV治疗新生儿呼吸衰竭疗效优于传统机械通气,并发症低,可作为机械通气治疗新生儿呼吸衰竭的首选模式。Objective To observe the high-frequency oscillatory ventilation（HFOV）and normal frequency mechanical ventilation（CMV） on the clinical effects of neonatal respiratory failure.Methods From September 2009 to January 2011 in our hospital neonatal respiratory failure,53 patients were randomly divided into two groups HFOV group and the CMVcontrol group.Observed 25 cases of neonatal respiratory failure in neonatechildren treated with HFOV,the CMVcontrol group of 28 neonates with respiratory failure were treated with CMV treatment,the two groups before and after the change in blood gas,oxygen concentration,computer time,complication rate and recovery rates were compared.Results Compared with the mechanical ventilation before the study group PCO2 decreased after 2h（P〈0.05）,and compared with the CMV group were is extremely signif icant difference between groups（P〈0.01）,8h later and thenit decreased very significantly（P〈0.01）.Compared with the CMV group were significant（P〈0.05）.Eight hours later HFOV treatment;observed 8h of mechanical ventilation function of the House of oxygen signif icantly improved,performance for the FiO2,OI,MAP decreased signif icantly（P〈0.05）,compared with the CMVcontrol group were signif icant（P〈0.05）,after 24h～48h the oxygenation is further improve,FiO2,OI,MAP were further decreased,signif icantly improved clinical symptoms in children.HFVO group compared with the CMV group have high cure rate,shorter duration of mechanical ventilation,pneumothorax and the incidence of VAP decreased（P〈0.05）,but III level and above,the incidence of intracranial hemorrhage was no significant difference（P〈0.05）.Conclusion HFOV treatment of neonatal respiratory failure than conventional mechanical ventilation,complications is low,can be treated with mechanical ventilation as the preferred mode of neonatal respiratory failure.

关 键 词：高频振荡通气 常频机械通气 新生儿 呼吸衰竭 

分 类 号：R722.1[医药卫生—儿科]